The thing about very high scores it that they can be thrown off quite easily and there is a lot of luck to it. I personally was scoring in the 13-14 range on both science sections during all practice tests. I got an 11 and a 10 on the real deal. A lot is up to chance.
This can be true, but not always. If you've prepped accordingly and don't screw up on the real test, you should be pretty set to score within your range. This includes those scoring 35-45 (the 'high' range pertaining to the 95th percentile).
I was scoring 14-15s on Bio and Phy Sci, and was getting 10-12s on verbal, and I ended up scoring nearly exactly what I expected, high ranges on them all. I attribute this entirely to be
so comfortable with the environment by the time I took it. The only thing I regret is not going in the center beforehand and getting frustrated by the typing of other students (which is no longer an issue without the writing section...). Even though I was in the extremely high percentiles, I did not vary more than 1/2 points.
However, it can be pretty unpredictable. Far back in the post history of this account you'll find another person who created this account, a friend of mine. He was expecting 80th percentile range and ended up with a 95th percentile score. He knew he'd done well, as he cruised through the sections and felt like he was making good time and good choices.
Meanwhile, I was expecting another friend of mine to score higher than me on the MCAT, he ended up scoring around 95th percentile even though he'd been in the 99th percentile range all along ('bombed' a section, went from scoring 15s to scoring an 11). He was well aware he did poorly on it, so it wasn't like he'd just unluckily gotten those questions wrong. He performed poorly and knew it. Unfortunately for him, he knows that retaking it is foolish since all scores must be reported.
All you can do is perform your best. It's a very well-designed standardized test and you can prepare for it very well for the time being. The changes will make it more interesting, though. In the end, the medical school you attend (as long as you get in) won't matter. So if you're shooting for the 95th+ percentiles to get into a top tier, it really isn't that important. If you crush the step 1 and perform well in any medical school, you can get into a residency of your choice.