Travel Nurse Bill Rate Breakdown: What Hospitals Pay vs. What You Get (2026)

Ever wonder what the hospital actually pays for your services—and how much of that you actually receive? Understanding the bill rate breakdown is your secret weapon for negotiating better travel nurse contracts.

What Is a Bill Rate?

The bill rate is the hourly amount the hospital or facility pays your staffing agency. This single number covers everything: your wages, stipends, agency overhead, taxes, insurance, and profit margin.

Example breakdown:

• Hospital pays agency: $115/hour bill rate
• You receive: $78/hour blended rate (68% of bill rate)
• Agency keeps: $37/hour (32% for overhead + margin)

The question is: Is that agency keeping a fair share—or taking advantage of you?

Typical Bill Rate Breakdown

Here’s where every dollar of the bill rate typically goes:

Your total compensation (wages + stipends) typically represents 55-70% of the bill rate.

What’s a Fair Agency Margin?

Agency margins vary significantly:

Important distinction: Margin is profit after costs. Total agency take (overhead + margin) is typically 30-45% of bill rate.

How to Find Out Your Bill Rate

Method 1: Ask Your Recruiter

Simply ask: “What’s the facility bill rate for this assignment?”

If they share it: You have a transparent agency. Use this data to negotiate.

If they refuse: That’s a yellow flag. Transparent agencies share bill rate information.

Method 2: Estimate Using Our Calculator

Use the Bill Rate Calculator to reverse-engineer the approximate bill rate from your pay package.

Method 3: Industry Research

General bill rate ranges by specialty:

Real Bill Rate Breakdown Examples

Example 1: Fair Contract

Assignment: ICU, California Bill Rate: $125/hr Your Package: $48/hr taxable + $2,200/week stipend

• Your blended rate: $48 + ($2,200 ÷ 36) = $109.11/hr
• You receive: 87.3% of bill rate
• Agency total take: $15.89/hr (12.7%)

Verdict: Excellent deal. This agency has minimal margins.

Example 2: Average Contract

Assignment: Med-Surg, Texas Bill Rate: $95/hr Your Package: $32/hr taxable + $1,600/week stipend

• Your blended rate: $32 + ($1,600 ÷ 36) = $76.44/hr
• You receive: 80.5% of bill rate
• Agency total take: $18.56/hr (19.5%)

Verdict: Fair, but there may be room to negotiate $2-3/hr more.

Example 3: You’re Getting Squeezed

Assignment: ER, Florida Bill Rate: $100/hr Your Package: $28/hr taxable + $1,400/week stipend

• Your blended rate: $28 + ($1,400 ÷ 36) = $66.89/hr
• You receive: 66.9% of bill rate
• Agency total take: $33.11/hr (33.1%)

Verdict: Red flag. Agency is keeping too much. Negotiate hard or find another agency.

How to Negotiate Using Bill Rate Data

Step 1: Calculate Your Current Percentage

Use the formula: (Your Blended Rate ÷ Bill Rate) × 100

Target: 70-80% of bill rate as your total compensation.

Step 2: Know Your Talking Points

If you’re under 70%:

“Based on my research, the industry standard is for nurses to receive 70-80% of the bill rate. My current offer puts me at 65%. Can we adjust the package to bring it in line with industry norms?”

If you have certifications:

“My CCRN certification reduces onboarding time and lowers the facility’s risk. That should be reflected in my compensation.”

If you have Epic experience:

“I’m Epic-certified, which means I can hit the ground running. Facilities pay premium bill rates for Epic-proficient nurses.”

Step 3: Get Multiple Offers

The easiest way to improve your bill rate percentage? Compare agencies for the same assignment.

Same facility, two agencies:

• Agency A: $72/hr blended
• Agency B: $78/hr blended

That’s a difference of $216/week for identical work.

Bill Rate Red Flags

Watch for these warning signs:

1. Unusually low blended rates for high-demand locations If California ICU contracts are averaging $85/hr blended and you’re offered $65/hr—the agency is likely keeping an excessive margin.

2. “We can’t share bill rate information” Transparent agencies share this data. Refusal suggests they have something to hide.

3. Blended rate stays flat when bill rates increase During high-demand periods, bill rates rise 20-40%. If your pay doesn’t increase proportionally, the agency is pocketing the difference.

4. Extension offers with no pay bump Extensions often come with higher bill rates (facilities save on onboarding costs). You should see that reflected in your pay.

Tools for Bill Rate Analysis

Use these free tools to analyze any contract:

• Bill Rate Calculator - Estimate bill rate from your pay package
• Blended Rate Calculator - Convert any package to hourly rate
• Pay Calculator - Full contract comparison with taxes and take-home pay

The Bottom Line

Understanding the bill rate breakdown shifts the power dynamic in your favor. When you know what the hospital pays, you can negotiate from a position of knowledge rather than guessing.

Key takeaways:

• Target 70-80% of bill rate as your total compensation
• Always ask for bill rate transparency
• Compare multiple agencies for the same assignment
• Use certifications and experience as negotiation leverage

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Have questions about a specific contract? Use our bill rate calculator to analyze your offer.