I sort of see two sides to this. On the one hand, the vast majority of students who start university thinking “premed” end up doing something else. Some cannot maintain a medical-school-worthy GPA in the tough premed classes. However, quite a few just find something else that they would rather do. One example is biomedical research (with a PhD track). There are of course lots and lots and lots of other different examples.
However, to me your ECs do make it look like you might have a bit more idea compared to most high school seniors regarding what is actually needed to be a doctor. Between this plus your excellent grades I think that you should be able to do this if you stick with it. I think that you definitely should budget with the idea that you may very well end up in medical school.
With a family income of $500,000, you are not going to get any need based aid. I think that it would be a mistake to spend close to your full university budget for a bachelor’s degree. As such, I would just drop Harvard, Yale, Stanford, Princeton, MIT, Cornell and Caltech from the list. I would not bother applying to them. This is just as well, since your list is too long.
I do not know how much merit based aid is possible at each of your other out of state and private options. You should of course check. You are a very competitive applicant. However, many of these schools only give very limited merit based scholarships.
I actually was wondering why these two schools were not on your list. They are both very good and you are in-state. Of course UC Riverside also has a very good medical school. You might want to figure out what UC Riverside is likely to cost you, and drop schools from your list that have no chance of getting at least close to this number (I am assuming that your chances for admissions should be pretty good for UC Riverside).
I think that I will put in a bit of an ad for UC Riverside, which also mostly applies to UCSC. You are a very strong student. You have done very well in high school. You have some very good ECs. You might think that this would allow you to attend a university that is higher ranked compared to UC Riverside (or UCSC). However, your goal is not to attend a famous university. Your goal is to become a doctor. UC Riverside is a very good university with a very good premed program and a very good medical school. It can keep you on the path to being an MD, and it can do this very well, and it can do this at a much more affordable cost compared to your high reach private schools. If you show up at university and you are in the top 1/4 of incoming students at whatever school you attend, and if you work very hard in university and keep way ahead in your class work, this might at least give you a slightly better chance of being the student who manages to pull off an 80 in that brutal mid-term exam where the class average is a 45 and anything over 70 counts as an A (but only a handful of students get a 70 or better).
One daughter was pre-vet, and attended a university that was not ranked in the top 100 in the US. Because she was pre-vet she took the full range of premed classes. She had a boyfriend who was premed who had never had a B in his life. Why did he attend a university that was not ranked in the top 100 in the US? It was affordable, he got very good merit aid, and it is a very good university. He is an MD now (and my daughter is a DVM). They both could have attended higher ranked universities for their bachelor’s degree. Instead they both kept their eye on the goal, attended an affordable undergraduate university, and ended up right where they want to be. You might want to think about whether you should aim for something similar.
I think of Caltech, Georgia Tech, and MIT as being somewhat similar and having a very math / technology / hard science orientation. If you have 800 on the math SAT, you might be pretty close to an average student at MIT or Caltech. There are certainly students that attend any one of these schools and go on to medical school, but I am not sure that this was the easiest or least expensive path for them to take on the way to medical school. I do not know CMU as well, but suspect that it might be similar. Getting merit aid at these schools also seems unlikely to me, although I am more sure about this at MIT and Caltech versus the other two.
Premed classes will be full of very strong students at a wide range of colleges and universities. You can get weeded out by premed classes at UC Berkeley or UCSC or any other school on your list. You will want to show up at university on day 1 planning to attend every class, always pay attention, keep way ahead on your homework, and make a very strong effort to do well. You are likely to meet many students in university who are exceptionally strong students such as yourself. This can be both thrilling and a challenge.
Students in very good MD programs come from a huge range of undergraduate universities. I once asked two doctors I know whether students in their MD program came from. One said “All over the place”. The other said essentially the same thing but with a less memorable quote. Other students I know who went to other types of biomedical-related graduate programs have said the same thing, as have students from other types of graduate programs.
You really can attend the University of Arizona, or Arizona State, or UC Riverside, or Princeton, or any one of 200 other schools, and go on to a very good medical school. I doubt that your chances of getting accepted to medical school is really going to vary significantly based on which of these schools you attend.
Not getting weeded out by the tough premed classes is mostly on you. This means picking a university that is a good fit for you. Then this means keeping your eye on the goal and working very hard as an undergraduate student.
If you add your $400,000 budget plus the federal $200,000 loan limit, I think that you should be able to get to the point that they hand you an MD with this budget. Given your great grades and test scores, I think that you can do this. Given your pretty good experience (for a high school student) in medical environments, I feel that there is a reasonable chance that you will stick with this goal, and if you change your goal to me it looks like you could do any one of a wide range of other things as well. I wish you the best.
However, you do need to focus on undergraduate universities that will be affordable, and will not eat up too much of your budget.