NVS cards are designed for financial business, multi panel displays, etc and not for gaming, hence the market is smaller than the gaming market which results in the higher price. It's not so much that it's old tech, just tech for specific business needs, primarily focused on multi monitor 2D display tech. You could look at a Quadro card but these are also expensive though more targeted at engineering and video rendering markets, lots of memory and 3D render capabilities but it will cost you. I'm not sure if Quadro drivers for Server 2003 are supported.  The NVS300 i think is the cheapest NVS card around.  Otherwise you could look your current setup and whether you have graphics driver issues with your two monitor setup. If the problem started around the time you have updated drivers, then you could roll back to an older driver revision and see if this may solve your issue. Otherwise, it may indeed be a hardware fault with the graphics card or the mobo itself, who knows... It's also important to remember that graphics cards are not supported by Dell on the T110 so there will not be any graphics card PEG connector to feed power to the card. The Dell T110 server does not have a graphics capable slot so it's again important to note that Dell states that each cards within a PCIe slot can only draw 25W of power max, not the 75W that many gaming cards will draw (and a graphics capable PCIe slot can provide).  Again NVS295 has a low 23W power draw and avoids other collateral issues...  Remember that the cost of fault diagnosis on your POS system and the associated inconvenience of working outside business hours needs to be balanced against the cost of purchasing and installing a new card and drivers. 
Our PoS server, a T110 running Windows 2003 x86 SP2 Standard, is our main interface for most of our business day-to-day.  But because the onboard video is just impossible to use normally, we added an older Radeon PCI-express card to supplement.  However, it's still not quite enough - at least not like it used to.  When running a dual monitor setup on HDMI and DVI, on a 1920x1600 and a 1600x1200, there's a lot of jittery motion when dragging windows (it wasn't like this before). We don't do any high end graphics, just A LOT of Microsoft Excel, huge spreadsheets, and multiple Windows to update PLU databases, print shelf labels, and the like.  My issue is that most video cards do not explicitly list Windows 2003 as a compatible OS. Given our OS and server type, what's the best compatible video card we should expect to work on this system?  The current video card is Radeon 4300.  It worked pretty well at the beginning, but after 3 years of 24 hour use, I think it's reaching its breaking point.
PowerEdge T110, Win2K3 Standard x86 SP2 - Best Compatible Video Card?