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What healthcare staffing actually costs

A hospital typically pays a staffing agency $65 to $120 per hour for a contract clinician, depending on discipline, state and urgency. Of that bill rate, roughly 55–70% goes to the clinician as wages and stipends, and 30–45% covers the agency’s employment burden, insurance, overhead and margin. Markup over base wage generally runs 40–60%. Nobody in this industry publishes these numbers. We think that is the wrong instinct, so here they are.

What is inside a bill rate?

The bill rate is a single hourly number that covers everything, which is why it looks high next to a staff wage. It is not comparable to a salaried employee’s hourly rate, because a salaried employee’s true cost to you is also not their hourly rate.

The components

  • Clinician wages — the taxable hourly rate
  • Stipends — housing and meals on travel contracts, where the clinician qualifies under IRS rules
  • Employment burden — employer payroll taxes, workers’ compensation, unemployment insurance, benefits
  • Professional liability — malpractice coverage carried by the agency
  • Credentialing and licensure — primary source verification, background and drug screening, immunization records, state license applications
  • Recruiting and account management — sourcing, screening, and someone who answers the phone at 2am
  • Margin — the agency’s actual profit, which is a smaller slice than most people assume

What does a travel respiratory therapist cost?

Travel RTs currently see gross weekly packages between roughly $2,300 and $3,600, which lands around $60–$70 per hour in total clinician compensation. Apply standard structure and the facility bill rate typically falls in the $85–$115 per hour range, higher for ECMO, neonatal and critical care credentials, and higher again in states where licensure takes months and supply cannot move quickly.

What does a travel MRI or CT technologist cost?

Travel imaging assignments generally run $2,000 to $3,500 per week in clinician compensation. Bill rates commonly land $80–$120 per hour. CT and MRI sit at the top of that band right now because vacancy rates in those modalities have reached record highs — and because an unstaffed scanner costs a facility considerably more per hour than the technologist does.

What does a locum hospitalist cost?

Locum hospitalists are typically paid $150–$200 per hour, averaging near $158, or roughly $1,800 per day. Facility cost sits above that once malpractice, licensure, credentialing, privileging and travel are included. Locums is quoted per day or per shift more often than per hour, and the rate moves sharply with notice period — a shift you need next week is not priced like a rotation you booked in March.

Why are two quotes for the same role so different?

Five things move a rate more than anything else.

  • Urgency. A start date inside two weeks costs more than one inside two months. This is the single largest factor.
  • Licensure friction. If the clinician needs a new state license, the pool shrinks to whoever already holds one. Scarcity prices itself.
  • Credential specificity. An RRT-ACCS is not an RRT. A dedicated MRI technologist is not a rad tech who has covered MRI.
  • Contract length and volume. Longer assignments and multiple openings both reduce the rate.
  • Shift pattern. Nights, weekends and rotating schedules carry differentials.

Is permanent placement cheaper?

Usually, if the role is genuinely permanent. Contingent permanent placement is charged as a percentage of first-year base salary, invoiced when the hire starts, with a replacement guarantee. You pay once. Contract staffing costs more per hour but carries no long-term commitment, which is the right trade when the need is temporary or the budget is not approved for an FTE.

The expensive mistake is using contract labor for eighteen months to cover a role that was always permanent. If we see that, we will say so — even though the contract is worth more to us.

How do we charge?

Contract and per diem are billed at an hourly bill rate quoted per role, in writing, before we begin. Permanent placement is contingent: a percentage of first-year base, invoiced on start, with a replacement guarantee. Locums is quoted per day or per shift.

We do not charge retainers on contingent work, and we do not invoice for a search that does not produce a hire.

What we will tell you before you commit

The realistic fill window for that credential in that state, the current market rate, and whether we think you actually need contract, permanent or neither. If the honest answer is that the role is fillable directly and does not warrant an agency fee, we would rather say that and keep the relationship.

Ranges reflect the national market as of 2026 and move with season, region and acuity. For a rate on a specific role in a specific state, ask us and we will quote it.

Want the number for your role?

Tell us the credential, the state and the start date. We will come back with a real rate and a realistic fill window, before you commit to anything.