a few who seem well thought of here for custom precision cuts of lab gems (as well as mined gems) are: Finewater Gems, Precisiongems.com, Stag & Finch and Jeff White. I don't know if they can do one that large but it's a starting point anyway.
You could try asking Tiyanu or Starsgem or Provence or one of the Chinese moissanite companies about their lab sapphire. You'll have to dig through the threads to find their contact info though as i have never bought from overseas. I don't personally love the colour or the way they cut their lab coloured stones though so I would rather stick with Stag and Finch first or one of the ones Seaurchin and DK suggested even if they are more expensive. I know they will turn out lovely stones, especially Stag and Finch since I have bought from them before.
Bigger stones take a longer to cut, and a lot longer to polish. Also for lab created blue sapphire, flame fusion material which is the least expensive is not an option for larger stones, so you would need Hydrothermal or pulled material which is rather expensive.
Figure for the rough the size you have in mind, could end up being several hundred dollars. Then the time to correspond, develop a design, saw the rough, cut and polish, photograph, invoice, package and ship could amount to 10 to 12 hours.
How much do you pay your plumber or furnace service guy per hour?
You can see that the finished stone will be well over $1000, unless you find some cutter who is willing to work for sweat shop wages.
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