Actually I started this because it's quite interesting and really most if not all of the hosts have no idea (I keep hearing references to "how expensive it is to make this" which couldn't be further from the truth).
In the "old days" you would draw a design or tell a jeweler what you'd like and they'd sit down and draw you up a picture (my local jeweler still does this). You'd discuss stone sizes and metal types.
Next, they'd CARVE you the design into wax, carefully making every detail. One mess-up and POOF, you'd have to start over. And the wax isn't cheap. If small side stones like diamonds are needed, they press them into the wax design (everything but the larger stones set with full prongs or bezel). After that, they pour a casting material called "investment" around the wax to make a mold of it. The the gold or silver is poured into that mold. The wax is melted out and the gold or silver grabs hold of the side stones, locking them in. This also involves a lot of "wasted" gold/silver as the items always have a hole and stem to follow down to the actual design. This stem has to be cut off and the whole item polished. The stem is later cooked back down and recycled for another casting run.
Then the main stones are added by hand. The prongs are usually VERY long, and carefully tailored and cut down to size then bent over and cut to final size. Then a final polish and it's done.
The other way it was/is done, is a jeweler has you look through a book of "pre-made" items. It's a "build your own mount" sort of scenario where different pieces are already pre-made by a large company and you choose what you want on your ring. The jeweler can then either have the company assemble it, or just have the items mailed to him for assembly. Used to be done with soldering tools, now done with special lasers. These items come with diamonds already in them, making for a quick process.
But the NEW WAY, is a bit different.
Now, everything is HIGH TECH. Items are designed on the computer with pricey design programs that have a substantial learning curve, jewelers charge $200 or more for a custom design, custom meaning anything non-standard they already carry.
They have special 3D scanning cameras that scan your gemstone to be mounted, to ensure a perfect fit (these are over $10,000), once everything is designed to your liking, it's sent to one of TWO types of printers:
WAX or Metal
Wax printers are 3D printers that print your item in, wax resin. Instead of carving it, the machine 3D prints it, allowing you to easily change it, or make many copies of it. This special wax is then cast just like the carved versions.
However, NOW (just recently) for a mere $50,000, you can BUY a 3D printer that prints in ANY METAL. The technology is still in development stages, but it's a significant advancement.
But what about faceting? isn't that a difficult art form?
Again, you'll hear hosts gloat about how "difficult something is", but they have no idea what they are talking about.
MOST faceting machines are quite high tech and do all the work for you, gem cutters are not free hand faceting stones.
There are NOW faceting programs on the market, that allow you to take a standard facet, and "modify it" any which way you please. You can see in the program how it would look on your stone and THEN decide if you want to do it. You then program the parameters into your faceting machine, and it goes to work FACETING IT FOR YOU. According to GIA, there are hundreds of "new" facet designs each day. And it's literally impossible to trademark or "copywrite" them (like SLC claims with the Portuguese cut or the asschur cut).
So while there ARE still small ma and pa shops that might cut by hand and eye, MOST places are taking advantage of advancing technology to streamline their work. And yes, it's still considered "hand cut" as you are still operating the controls somewhat
So let's do a cost breakdown for those of you who, like me, are trying to get into all this:
CAD program for design: $1,000
Gem Scanner: $10,000-$30,000
3D printer for wax: $300-$30,000
Decent computer to run everything: $1500-$2500
If you don't want to cast your items yourself (or like me you already take on too many new skills), you can send your completed wax forms to various casting companies. They can cast them in a wide variety of metals (some you've never SEEN before!). Some will even polish the setting and mount your stones for you, others only will cast.
I don't know that a gem scanner is a "MUST HAVE" item, but certainly if the gem is a custom shape it might make designing your setting far easier!
And while it seems like one art form is slowly dying, another is taking it's place (although you might argue it requires less talent).
And in regards to COST, these programs can TELL YOU how much material will be used and ALLOW YOU to thin it down and save $$$. There's now no such thing as saying one design is "harder to make" than another. They all print and cast exactly the same way. And those small stones are cast into place. I cannot speak on setting 50 stones into prongs, but I'd dare to guess they have some sort of machine to handle that too. But in regards to metalwork, all designs are pretty much equal with labor.
. I like being involved in the actual design input, but I don’t want to actually make the piece myself! As I said, there are small jewelers out there that are reasonably priced and definitely do masterful work and creations—-you have to do your research and choose carefully! BTW: I REALLY like supporting small local artists (and shops!) when I can and the owners and artists/jewelers are extremely grateful for their customers and the referrals! 
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about how well we worked together on the design and how well it turned out! He didn’t charge anything close to what you were quoted—-the other few designs that I have had done and helped to design were with other gemstones that I have purchased over the years. I haven’t used most of my loose gemstones in jewelry creations. One, I can’t afford to do that with the tons of gemstones that I have purchased over many years 
for listening!
Look into the program called "Blender", it's a 3D program and I think free to download. "Rhino" is the big program most places use, they DO have a free 90 day download period so you COULD play with it a bit (and LOTS of good videos on YouTube plus a help forum on their website for tips and tricks). Heck, tell the hubby you want a 3D resin printer for Christmas, and get rocking those designs! If you design and print your work, you'll save a heck of a lot of $$$ and be able to make stuff to sell (just check state laws as some require special licensing to sell gold or silver).