2012 2500hd 6.0 3.73 6 speed 6l90e tranny.
I tow about 8000 lbs with it and usually head through central VA into WV so most of it is low altitude mountains. It does very well and gets maybe 8-9 mpg. Just set the cruise at 65 and steer. It might wind up to 4k rpm on the 6% climbs but otherwise it runs at 2300 in 5th on the flats to small hills and 3100 in 4th to get up the moderate hills.
I am very satisfied with it and I would not call the 4.10 a must have for towing with the 6.0. It probably won't let you hold a higher gear that often so most likely you will be in the same gear just turning a few hundred higher rpm.