Noise Ninja and Neat Image are quite good, and work about the same way. I can't tell any difference from one to the other. After using both, I bought Neat Image, not because it's better than Noise Ninja, but because I got a nice school discount for the Pro version. I could have gotten a similar discount from Noise Ninja (I imagine), but only needed one of the two applications.
Neat Image allows for having total control of the amount of noise reduction one wants. Here are some of the features available with the Pro version (v. 4.7). I use it with PSE6, but it also works with CS4, etc. It's just a Plugin like PSE's "Reduce Noise" feature. Neat Image appears at the bottom of the "Filter" menu in PSE. PSE's "Reduce Noise" appears approximately half-way down the filters. The Pro version supports both 8 and 16-bit images, while other versions only support 8-bit images. That's why I purchased the Pro version. I don't remember how much I paid for the plugin, but a full version that is not discounted costs around $60.00, I believe.
Noise Reduction and Image Sharpening
• Advanced noise filter to reduce noise and grain in digital images
• Complete control over the filter settings to achieve the desired level of noise reduction
• Smart sharpening filter to make images look sharper without amplification of noise
• 16-bit image support to fully utilize capabilities of modern image acquisition devices
Photoshop plug-in
• To selectively apply noise reduction to layers and channels
• To streamline use of noise reduction in your workflow
• To automate workflow using Photoshop actions with Neat Image noise reduction
Device Noise Profiles
• Auto profiling to build noise profiles for your camera or scanner on the fly
• Rich set of free pre-built noise profiles in the online profile library
• Profile matcher for automatic matching of pre-built noise profiles to images
Please note that I am not advertising this product whatsoever. I am certain that Noise Ninja works just as well as Neat Image.