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Most pre-med students are aware of the cost of attending medical school, but many are unprepared for the high financial costs associated with the medical school admissions process. This paper uses detailed data from 8 incoming medical school classes at one medical school in the American Southwest to understand how much students are spending to engage in the U.S. medical school admissions process. This study breaks down costs into each step of the process and disaggregates by race, ethnicity, first-generation college student status and socioeconomic status. The final year of data (entering class of 2021) includes the first class to apply during the COVID-19 pandemic for discussion about ways to reduce costs to students.