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BG rentacar companies will not alow BG reg car into MK, but Albania will do, just will charge you extra for green card.
www.sixt.de will have best prices for Albania..
I now a low budget rental company that also works in Bulgaria, its name is RENTACAREASY.COM. I have been renting from them over the last year at many European destinations and I am very satisfied with their services, and of course, with their price :-)
Hertz will allow it from Bulgaria if you contact the office in Sofia directly (its a franchisee) - Hertz Corporate say it is not possible, but just ignore them. The greencard will cost you 30 Eur + VAT
There are many other local companies that also allow it charging 25-50 Eur. Try google