R-22 Freon is being phased out & isn't readily available. So the service company may only purchase as needed and the lack of availability would make their cost high. But, as long as they can get it, whatever the cost, unfortunately, is less expensive than replacing the A/C. Which will be the case eventually since it's no longer manufactured or sooner as in my case with a not so old a/c that sprang a leak, that would have been just a repair, but since it uses R-22 the whole unit has to be upgraded(replaced).  
After major damage to a small addition on our home was damaged in the windstorm in May, the insurer’s preferred vendor sanded drywall without taping off the area. They relied on heat from the furnace to dry the mudding compound. They claimed they shut the furnace off while sanding and regardless of whether they did or not, they never cleaned up the drywall dust before turning the furnace back on. I now have drywall dust everywhere and my husband took photos to verify our concerns. They even sanded right above a cold air return. Vents were never covered either. The same company that created this mess is cleaning my ducts today. They have refused to clean the furnace. Their are health concerns for my almost 85 yr old mother who resides with us. I’ve tried 3 times in the last 7 days to escalate to a manager and they will not return my call. They just keep sending it back down to my adjuster. There are many other issues we’ve encountered since May as well. This is a major insurance company who has the resources to fix this mess but refuse. Please help!

NADCA and EPA both have good points. Although, organizations are made to make money. Common sense and looking at NADCA and EPA pre-checklist. If you don't see it in the check list, you don't have to do it! But, if you do, look up Diamond certified co.s and the BBB. Beware of bait and switch scams, $60 vents and the like coupons which claim to help all for the measley sum of $79.00 bucks.
Professional cleaning involves getting the dust and debris outside, so they use outdoor ventilation equipment. It is so important that homeowners make sure the professional contractor is using good equipment then, as they could otherwise spread the spores into the home and further agitate sensitive family members. In the case of mold, a cleaner will only be able to tell you it is there, followed by needing an additional mold professional to come out and test or remove the mold. Air duct cleaning industries do not require state licensing, so make sure to check for a company with references.
Having the most energy-efficient system ever built won't matter much if it's not maintained. Lack of maintenance is the number one killer of HVAC systems. Before each cooling season, it's recommended that your system get a professional tune-up. However, there are things you can do in the meantime to make sure your system runs efficiently throughout the year.
HVAC professionals in the US can receive training through formal training institutions, where most earn associate degrees. Training for HVAC technicians includes classroom lectures and hands-on tasks, and can be followed by an apprenticeship wherein the recent graduate works alongside a professional HVAC technician for a temporary period.[33] HVAC techs who have been trained can also be certified in areas such as air conditioning, heat pumps, gas heating, and commercial refrigeration.[34]
PickHVAC Tips: First, see the PickHVAC tip above about sizing a central air conditioner. It applies to heat pumps just as much. Secondly, Even if the line set for the new heat pump is the correct size, we recommend replacing the set or at least the fittings. Old lines and fittings are a major source of leaks. When refrigerant leaks out, the heat pump efficiency suffers. Eventually, the unit stops providing heating and air conditioning, and it might break down.
The fact is if they are dirty why not clean them. As for the Dr’s comment about if it is not disrupted it is fine. As a pet owner sometimes un disrupted pet hair will sit in the corner of a room or under a counter un disrupted but I still clean it when I notice it. Just because you cant see it doesn’t mean you should leave it there to collect more and more. The people that don’t want there air ducts clean either simply cant afford it but would like it done. OR! the crowd that are to cheap.. You should Clean all portions of your house.
The final cost of this service is best determined after a professional inspection. Many air duct cleaning companies build their prices based on individual services, while others offer package pricing which includes such components as the air conditioning and furnace. The following estimates can give you an idea of prices to expect for various services.
"Customer service was great, and the price was in-line with other places, and fast service. We had a whole replacement of the outside and inside. I would have liked to see a better install for the furnace and new thermostat - the new thermostat should have gone where the old one was, and even tho the new furnace was a tight fit, they didn't offer to come back and repair the case molding, or give me a discount on the damage done, and I believe they should have put a disconnect box on the outside of the home, to make it easier for any future repairs needed. Other than that, am very happy with the cooling and heating!"
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