How different is the work between more or less prestigious firms?

I work at a moderately ranked Amlaw 100 firm, doing mostly software for big tech companies. The work is somewhat interesting but the technology rarely knocks my socks off. I'd say 10-20% of the patents I write have been or ever will be implemented.

Is it completely different at the Fish and Finnegans of the world? Or the well-known boutiques?

Are their Associates working on super-cool, bleeding edge tech that is critical to the line of business of major tech companies? Or is everyone doing the same kind of stuff?