<p>Standardized tests don’t seem to seem to put you in a favorable position applying to top top schools (work on that reading!) but it will be noted that you are a val which will help you out…for pre-med/BME, Duke is also an excellent option (though engineering is always a tough major for pre-med because of the difficulty). Dartmouth too is a great choice for pre-med. But of course these schools are expensive w/o any aid; though, such schools are generous with aid so don’t write off the possibility. The fact that you have a twin will certainly be factored into the equation. Otherwise yeah, it seems like applying to state schools may be the cheapest option if money is the key issue - as you may well know, for med school admissions, undergraduate school prestige is overshadowed by all the other factors when applying to med schools.</p>