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Are there any geo areas where ATT+TMO/Sprint (combined due to merger) isn't at parity with VZ?

I live in a mountainous area, and there is a very large difference. So much so that VZ is basically my only option.

I think what happens is that tower leases in some protected areas can be hard to negotiate, so the cost/benefit ratio gets out of whack for new towers (amongst other issues with power, construction, and RF propagation in remote, mountain areas). Maybe someone with more knowledge can chime in.

Towers are typically owned by a REIT (real estate investment trust) or other entity that develops the tower and telco/equipment shelter and then leases out space on the tower to mobile providers (cost is higher to the mobile provider the higher you want to be on the tower).

In some locations, there just isn't any land to site the tower due to regs (national parks comes to mind, nothing except my Iridium hotspot works in parts of the Smokey Mountains), so there are no providers or a single provider who was able to swing a special case on an existing tower (water tower or similar).

Yes, many. Verizon is still the only option for reception in many areas—I live in Los Altos Hills, and the only provider with reception for much of the town is Verizon.

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