I always looked at a managed server as meaning they'll manage the SERVER, not manage the sites or install and configure uninjured amounts of third party scripts.
Sure if you're a long term customer they might do one as a favor every now and again, but I wouldn't expect them to be doing it all the time without charging for it. This if only because some scripts can take an hour or more to set up, then the webmaster changes their mind and wants a different one, etc. I wouldn't WANT to pay enough of a premium to cover unlimited work like that. The 90% of customers who don't need the extra hand holding would be paying for what they don't need.
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