I was lucky enough to get a fiber setup a few months ago with Monkeybrains for the school. We have it sitting behind a Peplink Balance router and have Comcast Business as a backup. It has been great to get rid of the larger ISP vendors like AT&T and Verizon. We also have become a wireless point for them for other customers. So, we are able to give people around the neighborhood another options besides the two big players here in San Francisco. Rudy and Alex have been wonderful to work with and our students and faculty are getting blazing speeds.
When you get fed-up with the other ISPs, you should drop them a line and see if you can either do point-to-point wireless or, if you need a beefy connection, work with them and the City as we did to access dormant fiber.
More info at http://www.monkeybrains.net/