I live rural and CenturyLink has a complete monopoly in this area.
I had dialup through CenturyLink until 2006, because every time I asked them about their DSL service I received the same bull about being in an extended service area and how the performance to my address would degrade. Shortly before it became impossible to get a tech to your address any more (they ship replacement hardware by UPS, etc.), I talked to the guy that was maintaining our lines (the same guy who responded to every service call here for years) and he agreed to fib a little on our account to place us inside what he told us was a 4-mile radius of the nearest DSL switch for availability. CenturyLink gave us 512 kbit ADSL (which is currently $75/month), and the rates coming through are greater than what they're supposed to be (approximately 72 kilobytes per second down and 40 up). So much for "degraded service".
Now for the last two years, I've been getting the exact same speech about being in an extended area and would suffer degraded service if they would throttle me to any higher available package. The connection is rock-freakin-solid and the only time I've ever had an internet outage was when the power was out, but they continue to refuse to take my damn money for some reason.