Anything more "exotic" will depend on the specific garment. Lots of adventurous tailors around there, but some items are just fundamentally better suited for mass production.
I don't think you'll need six figure spends unless you want something particularly difficult to make. Everything weird is going to be expensive though, developing a whole new pattern takes a while.
vnapersona bespoke by Maurizio Altieri looks fascinating, I'm not sure how attainable it is though.