When my oldest—who just graduated from college—was a toddler, we had a friend who was in medical school. Somehow we got to talking about tuition, and I was stunned to hear that we were paying more for my daughter’s preschool than the future doctor was paying. That just didn’t strike me as the way the world should be. Sadly, in the 20 years since then, very little has changed.

The nonprofit Child Care Aware of America just published a report about the cost of child care around the country. They found that full-time care at a child-care center for an infant ranged from a $4,863 per year in Mississippi all the way to $16,430/year in Massachusetts. Care for a 4-year old at a child care center was a comparative bargain, costing $4,321 in Mississippi to $12.355 in Massachusetts.

Why the big difference? A lot of it has to do with labor costs (in states where basic living–rent, utilities, etc—are high, it costs more to hire child care workers). In addition, rents paid for the centers themselves are higher in areas where real estate prices are high. Oh, and let’s not forget about licensing regulations. The Child Care Aware report notes that while regs allow for one caregiver per five infants in Mississippi, regs in Massachusetts only allow a 1:3 ratio.

But regardless of the location of the center, a typical family of four spends more per month on caring for an infant than on food. In nearly half of the states, parents pay more for center-based infant care for one child than they pay in rent (in 20 states, child care costs more than the average mortgage payment). And in all 50 states, parents with two kids in center-based care paid more than rent. Getting back to the preschool vs. medical school tuition issue, in nearly two-thirds of the country, average child care costs were greater than yearly tuition and fees at a four-year public college. That’s just frightening.

report released Monday — Titled “Parents and the High Cost of Child Care,”

See Child Care Aware’s list of the top ten most expensive states for child care below: