Damn, you got some high scores there, brother! What processor and RAM do you have?
http://www.newegg.com/Product/Produc...82E16814125258
This card is fanless, and I have a friend with the 4850 and 1GB GDDR5 and gets great framerates and a 5.9 rating, although this card has GDDR3 memory, so its memory is a tad slower. Getting high ratings without a fan is tough unless you go water-cooling. If you OK the fan, then there are tons of options out there. The new NVidia 295 chipset is about the best you can get (2 GPUs, 2gb memory, crazy fast, crazy expensive)... I have the ATI HD4670 chipset with 1GB GDDR3 memory, and I am very well pleased. I can run Crysis at 1920x1080 on High settings with 60+ fps, and completely maxed out at 1280x1024 at around 45 fps... You can also always buy any card and take off its fan and heatsink and replace it with a massive heatsink and just keep an eye on temperature under heavy use for a while to make sure its within the tolerable range....
Just my $0.00002
-Daniel