Locums - recruiter or DIY?

Question for those that do or have done locums in the past. I've head the advice that if you can figure out what hospital is looking for locums (based on location, volume, trauma designation, etc) then it behooves you to reach out to that hospital yourself and see if you can negotiate a higher rate and cut out the locums agency.

How has that worked out for people? I'm eyeing a locums site about an hour away that I know for sure is USACS, but I know they have their own "regional traveler" thing and I'm somewhat worried that they will try to lowball me or pigeonhole me into that role. I've also heard that once a site sees your CV then it's like 2 years or something before a recruiter can present you to that site -- would that apply in this situation, if I was the one that contacted a site myself? Would that apply across all of USACS or just at this one site?