Getting tested for strep throat is straightforward: visit a doctor’s office, urgent care center, or retail clinic, where a provider will swab the back of your throat and run a rapid test that returns results in 10 to 20 minutes. If the rapid test comes back negative but strep is still suspected, a follow-up throat culture may be sent to a lab for confirmation. Here’s what the full process looks like and what to expect at each step.
Where to Get Tested
You don’t need to schedule an appointment with your primary care doctor to get a strep test, though that’s always an option. Urgent care centers and retail walk-in clinics (the kind inside pharmacies and grocery stores) can perform rapid strep tests on the spot during a standard visit. Most urgent care locations let you check wait times online and reserve a spot ahead of time, though they still prioritize patients based on severity and arrival order.
Without insurance, a rapid strep test itself typically costs between $22 and $49, though you’ll also pay for the office visit. With insurance, a strep test is usually covered as part of a sick visit with a standard copay.
What Happens During the Test
The swab procedure is the same whether you’re getting a rapid test or a throat culture. You’ll tilt your head back and open your mouth wide. The provider uses a tongue depressor to hold your tongue down, then rubs a sterile swab firmly across the back of your throat and tonsils. The key areas are the tonsils, the tissue pillars on either side of them, and the back wall of the throat. Swabbing other parts of the mouth can lead to false negatives, so expect the provider to reach fairly far back.
The whole thing takes a few seconds. It’s uncomfortable and may trigger a brief gag reflex, but it isn’t painful. You don’t need to fast or avoid eating beforehand.
Rapid Test vs. Throat Culture
There are two types of strep tests, and they use the same throat swab.
A rapid antigen detection test searches for specific proteins on the surface of strep bacteria. It delivers results in 10 to 20 minutes, right in the exam room. Modern rapid tests detect strep correctly about 92% of the time and are 98% accurate when they come back negative, meaning false positives are rare.
A throat culture is a lab test where the swab sample is placed in a dish and given time to see if strep bacteria grow. Results take two to seven days, with most bacterial cultures finishing in about two days. Throat cultures are more sensitive than rapid tests, which is why they’re used as a backup when a rapid result is negative but symptoms are suggestive.
What Happens After a Negative Rapid Test
This depends on your age. For children older than 3, CDC guidelines recommend that a negative rapid test be followed up with a throat culture. The reason is that untreated strep in children carries a small but real risk of rheumatic fever, a serious inflammatory condition that can damage the heart. Your provider’s office will contact you if the backup culture comes back positive and start antibiotics at that point.
For adults and teens, a backup throat culture after a negative rapid test isn’t routinely recommended. Rheumatic fever is very rare in these age groups, so the rapid test alone is generally considered sufficient.
How Providers Decide Whether to Test
Not every sore throat warrants a strep test. Providers use a scoring system to gauge the likelihood of strep before deciding to swab. The criteria include: fever above 100.4°F (38°C), swollen tonsils with white patches, tender or swollen lymph nodes in the front of the neck, absence of a cough, and the patient’s age. Younger patients score higher because strep is more common in children.
If your score is very low, particularly if you have a cough, runny nose, and no fever, those symptoms point strongly toward a virus and testing usually isn’t recommended. Strep throat almost never causes a cough or nasal congestion, so those are useful clues even before you see a provider. A higher score means testing is warranted, and a very high score sometimes prompts providers to begin treatment while waiting for confirmation.
What About At-Home Strep Tests
You may have seen strep test kits sold online, but no over-the-counter strep test is currently FDA-approved for use by non-medical professionals. The kits that exist use the same rapid antigen technology as clinic tests, but when performed at home they detect strep correctly about 86% of the time, compared to 92% in clinical settings. A negative home result is accurate roughly 95% of the time.
The lower accuracy likely comes down to swab technique. Getting a good sample from the back of the throat without a tongue depressor or proper lighting is difficult, and an inadequate swab is the most common reason for a false negative. If you use a home kit and get a negative result but still have classic strep symptoms (sudden sore throat, fever, no cough), getting tested in a clinical setting is the more reliable path.