Personally I'd go with a complete Thermalright setup, I just love how well their products are made, how well they function and I like the no nonsense good looks.

They have coolers for freakin' everything. It's pretty daunting and likewise, pretty expensive. But that's the cost of the top.

I found something on the thermalright website where somebody used some variant of the HR-03 cooler and the V2 both on the same HD4870 X2 card. Looks like that might work in the mean time.

Nevermind! Cured it with some idex cards, scotch tape and a re-application of thermal paste.

is it possible to get it at with just the stock heatsink for less?

It is close really to my videocard budget of $50 and is right up my alley in terms of power consumption + performance.