BISMARCK, N.D. - A new Market Watch survey lists Walmart as the largest private employer in 18 states, including Montana.
Universities were the number one in payroll for nine other states.
Eleven states have health care providers as the top employer, including The Peace Garden State.
Sanford Health, with 12,000 workers is the largest private employer in North Dakota.
"It's a family-orientated hospital. My team members are like my family, our patients are our family too, we treat them just like family. It's a great place to work, our supervisors are really great, they make sure that we have everything that we need," said Certified Surgical Technologist Selena Vanhout.
The Executive Vice President of Sanford Bismarck says the reason Sanford is so big is because healthcare is important.
"All of us who work in healthcare think that healthcare is really the foundation of what drives the economy, what drives industry. So between healthcare and education, we are the foundation for what drives this economy, what makes things work," said Bismarck Sanford Executive Vice President Craig Lambrecht.
Selena says her supervisors at Sanford are a huge factor why she loves her job so much.
"There's always an open-door policy, if ever we have a problem that we need resolved we can easily go to their office and we can talk it out. They're always there to make sure our problems are resolved," said Vanhout.
Dr. Lambrecht says having over 10,000 employees working for Sanford is a loud voice and responsibility, because all the employees have a passion for giving good healthcare to their patients.
Health care providers are also the number one employers in South Dakota and Minnesota.