Mangione comes from one of the wealthiest families in Baltimore and was valedictorian at the elite Gilman School in Towson.

Luigi Mangione appeared in court Monday to face his New York state charges in the death of UnitedHealthcare CEO Brian Thompson.

Now, less than a decade later, Mr Mangione has been charged as a suspect in the high-profile killing of a UnitedHealth executive in New York City – a brazen shooting that set off a tense five-day manhunt that culminated in his capture.

The clean-cut streets outside Baltimore where Luigi Mangione grew up are a picture of suburban idyll: Tidy lawns, flowering bushes, stately Colonials and Capes in muted colors. Mangione enjoyed all the trappings of that privilege.

Mangione's hearing on state charges comes days after his dramatic return to New York to face federal counts in the slaying of Brian Thompson.

Luigi Mangione pleaded not guilty Monday to state charges in the murder of UnitedHealthcare CEO Brian Thompson.

During a Monday hearing, attorney Karen Friedman Agnifilo said the "spectacle" around her client was "absolutely unnecessary."

UnitedHealthcare CEO slaying suspect Luigi Mangione appeared in a Manhattan court to face murder and terrorism charges.