Hi Brandon,
The short answer to your key question is - no, there is not currently a tool that provides reliable geo terms. Even if you are in a major city, like LA, you cannot really rely on any tool for this. The reason for this involves data centers, IP addresses, etc.
So, how to Local SEOs conduct keyword research, then? Good question! Here is how I do it, and how the other Local SEOs I know handle this task:
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Perform your keyword research without any geo modifiers. Search for your brand, your services and products and create a spreadsheet of the terms you discover.
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From this list, create a second list including your geo terms. These might include city names, county names, neighborhood names, regional names and zip codes. They might also include modifiers like 'in' (i.e. computer repair in green bay).
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You now have the most reliable list of keyword terms to target.
While there isn't a kw tool that can take the place of this method, I recently became aware of an interesting free tool that helps you generate geographic terms, by themselves. You might like to check this out in helping you determine good geo keywords to add into your list in step 2:
http://www.localmarketingsource.com/local-keyword-research-tool/
Google Insight does provide some help, but don't overlook the most important factor - listening to what your customers call who you are and what you do. If you've been in business for a long time, you may have become aware of interesting terms your customers use that aren't necessarily in-house terms for things. Definitely, look those terms up to see if people are using them to search.
Good luck with the task ahead!
Miriam