The bottom line is: no one knows. There are examples of ducts that have become badly contaminated with a variety of materials that may pose risks to your health. The duct system can serve as a means to distribute these contaminants throughout a home. In these cases, duct cleaning may make sense. However, a light amount of household dust in your air ducts is normal. Duct cleaning is not considered to be a necessary part of yearly maintenance of your heating and cooling system, which consists of regular cleaning of drain pans and heating and cooling coils, regular filter changes and yearly inspections of heating equipment. Research continues in an effort to evaluate the potential benefits of air duct cleaning.
The cooling coils the air comes into contact with appear to need UV-C lights on them in humid climates. That's the biggest thing. If the ducts have never been cleaned, then getting that done goes without saying. But those coils need to be cleaned, disinfected, and then UV-C light(s) installed to prevent mold & bacteria build-up in the future on them. That appears to be chiefly responsible for the dirty laundry and/or sour milk smell coming from forced-air AC systems in humid regions.
I live in Port Orange, FL. I purchased a double wide mobile home and was saddened to learn that the previous owners were HEAVY smokers! They did a good job “hiding” the smoke smell the day we viewed this place. I did not have a home inspection done unfortunately. My question is: can duct cleaning remove the smoke smell from this place. The ceilings have been treated with Kilz and paint. I personally scrubbed down every wall, floor or surface. I also purchased a ODORFREE OZONE machine. It seemed to remove the odor for a short period of time but my friends are again complaining about the “smoke” odor in my home. The Ozone machine was $400 and I’m terribly upset that it didn’t clean the air as was promised.
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).  
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