I'm with you. It sounds like for any application that would use Twilio extensively, it might be better to roll your own. (not that I know how exactly, but I've read here someone saying it wasn't too big of a deal)

For example, if you have an app where one user would need to be on the phone say 6 hours a day, (could see that easily for customer support or sales) it goes to over $200 a month for a single user. You can probably find products and markets where that's fine but, it's difficult when compared to the typical price range of web-apps. Unless Twilio offers better pricing if you're a heavy user…

However, for applications where calls or text messages are a nice addition and not the core, it's nice to have services like these available.