Sounds like you might be a candidate for J. Crew. I wouldn't worry too much about the construction. If it fits and you like the style, you'll look good. Other options might be Benjamin at eHaberdasher, or Howard Yount.
I believe with BB MTM that you start with one of their existing models (Fitz, Milano, etc), and then make minor adjustments so it fits you better. Unless you want to make drastic changes, I don't think you can go too far wrong.
Don't know about cost, but I'd assume it will cost more than the pants. Definitely worth doing. I've never done it on a suit, but I did on a shirt and it improved it greatly. Nice buttons won't be cheap either.
I am the same size as you, and I just bought a Borelli that was reasonably slim fitting (although not hipster slim.) I think a lot of the more expensive brands are cut larger, because their typical clientele are older / larger, but they usually have some slimmer fitting styles.
Visited the STF warehouse the other day looking for a birthday present for a friend. (Of course, I wound up buying a suit for myself, 'cause that's what SF does for you...) Hadn't been since he was in Venice. It really is worth a trip if you are visiting LA. Kind of like the top floor of Nieman Marcus, but at wholesale.
And iff anyone needs a proxy, I'll be happy to provide the service. My fee will be a very moderately priced trinket off their shelves...