I am speaking about my vets' office, only.
I think they are very reasonable. I've referred other people to them who complained about how much their former vets charged. Plus my vet has been giving us a 15% discount for several years now just because of pure volume (3 dogs, 4 cats right at this writing, but more critters at other times). This includes meds, preventatives (heartworm and fleas treatments), surgery, etc.
We have never been charged for euthenasia. Toenails are clipped for free. And they always make a donation in our pet's name to the Texas A&M Vet School when one of our furkids dies.
Specialists? That's a whole other thread.