I've been to a few smaller PCB fabs a few years ago, before the days of 4PCB and PCBExpress and the like - mail order, nearly overnight, you fit it into their process flow shops. Anyway, this is back when a 4 layer board run was a $2k/2 week kind of deal rather than the $500 or so you can get now (or cheaper if you can wait). Those places were FILTHY and smelled like all kinds of hell. Nasty business. It's amazing how far these guys have come.
The value is so much better now too. Ten years ago, to get an overnight board we used to mill out two layer boards using a piece of prepreg with copper on either side. A guy would machine off all the copper we didn't want, then drill holes where we needed vias to connect from one side or the other. Then I had to fill the vias with little pieces of wire and solder each side, then stuff the board, then test and debug it; over repeated rework cycles the board would start to peel apart. On top of that, if you get the board hot enough, the vias (wires) would fall out and that was pretty hard to figure out. It was gravity assisted current limit.
Now, you finish your board design and ship it off to one of these guys. During the time you used to spend getting to square 1 with the milled board, you could order parts and then the board shows up from one of these guys like 4PCB here. A 2 day turn on a 4 layer board is no problem and just a few hundred bucks. The time I spent soldering vias into the milled board cost more than the real PCB I can get now. It's amazing. The way they get the price down is a combination of two things - first, you fit into their process flow, as I mentioned earlier. That means that they don't look at your board, they don't think about your board, they just cram it on a panel with some other guys' boards. If you want slots made in the board, you don't get 'em; if you want internal routs cut out of your board you don't get 'em. You get what their process says it does, and so does everyone else. This leads to the second way they get price down - volume. Lots of guys now order from a couple big shops, rather than these little (pretty dirty, as I mentioned) little mom-n-pop PCB houses. And we all order the same process.
It's amazing to see how some of these basic market principals have worked in the past ten years, and it has made a huge change in the R&D industry. It's much easier to do a pilot run of a board, it's much easier and cheaper to make a limited run, and since you are risking less you can order more and try things out. Truly awesome for an electrical guy.