I'm running dual GTX 280s in SLi and I cranked AO on high in Left 4 dead, it was a massive framerate hit.
on low it's not noticable at all, but does offer some nice improvments. on medium or high I can notice the framerate drop
That sounds about right. AO scales with the resolution at which it is applied. If you game at a high resolution, say 1920x, and AO at 'high' means that it applies it at that resolution, it'd have much more of an effect than going down a few notches. Half the resolution AO is applied to means 1/4th of the processing power needed, roughly.