I would think in most cases, not all, that a good bench jeweler could modify
what you need done. And as Peter said, they should be able to order you in
the exact same setting with the correct stone size.
Most good jewelers, give em a torch, some gold, and the other required tools
and they can make it happen. But, the cost may be more than it would be
worth to you to have that done when you can just order in what you want to
start with.
---Lazy
http://www.funcraftics.com