You can go with an aftermarket muffler in leiu of a cat-back and gain an amount of HP increase.
As far as a muffler preference Flow-Masters are good, though on some engines they sound crappy (I haven't heard one on an X yet). I would suggest going to a reputable muffler shop and get some advice from them...they see exhaust systems every day and can usually suggest something that would sound good/work well on your truck.
FWIW I tried a straight-through "turbo" muffler, it sounded like CRAP! ... Though Gibson uses straight-through mufflers, and they sound good. The total-package benefit is what you get when you go cat-back.
...Or you could go for the Cholo sound and go with twin 24" cherry-bomb glass-packs, and 1" pipes!