My brother-in-law has been a long-time DirecTV customer, and he faced the same litany of extra fees when he wanted to add HD programming. Dish was offering comparable service for significantly lower cost. So, b-i-l called DirecTV and had a little chat with a rep about how they were about to lose a long-term customer to Dish because their prices were too high. After some debate with them, he got DirecTV to match the Dish pricing. Based on the number of promo flyers I get every week, I don't think any of these service providers are doing so great that they can't be persuaded to meet the competition's pricing.

My wife and I have been mostly satisfied with Cox Cable. We had digital cable before we went HD last November, so the cost to upgrade was only the difference in price between the HD box and the standard digital cable box ($6-7). One tier of HD channels was no extra cost over standard digital cable, and this was all the service we required. We don't subscribe to any premium channels, and we only need one cable box. We also added an HD DVR, so our monthly bill went up $17.