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.
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.
Vacuum the ducts as much as possible. Consider renting a heavy duty vacuum for this purpose. The standard household vacuum isn't powerful enough to clean deep into the crevices of the ducts. Make sure that the vacuum you rent has a long hose to reach deep into the ducts. This is important, as there may be mold and mildew growing inside the air ducts [source: Repair Home]. If you want the ducts to be cleaned more thoroughly, consider hiring a professional to do the job.

Chemical biocides are regulated by EPA under Federal pesticide law. A product must be registered by EPA for a specific use before it can be legally used for that purpose. The specific use(s) must appear on the pesticide (e.g., biocide) label, along with other important information. It is a violation of federal law to use a pesticide product in any manner inconsistent with the label directions.
And if you have flex duct and/or fiberglass ductboard in your home- the last thing you want is a big brush or anything abrasive running through it. Even high-pressure air can erode ductboard so I wouldn’t clean it with anything. If it becomes contaminated, get rid of it and install real ductwork. If your ductwork is accessible in the basement – the best thing to do is take it down and manually clean it if it’s full of junk. It’s not going to cost a nickel more to do that than to pay $500-1000 for a ‘duct cleaning machine” AKA big blower and vacuum – to do the job.
What about ringworm? If the fungus is as contagious as doctors warn, and the spores can live several months, doesn’t it make sense to spray some sort of fungus killer into the HVAC system to kill the spores that it has sucked in from the air? Duct cleaning would not be helpful at all here; these spores are microscopic and it could actually spread them further. But given how severely contagious ringworm is, body and especially scalp, does anyone make an aerosol product that will clean the system and kill the fungus? One the resident can use, not call an HVAC company; you can’t do that when you are in an apartment. I hear it’s not the same as mold, it is much more difficult. Truth?
In addition, the service provider may propose applying chemical biocides, designed to kill microbiological contaminants, to the inside of the duct work and to other system components. Some service providers may also suggest applying chemical treatments (sealants or other encapsulants) to encapsulate or cover the inside surfaces of the air ducts and equipment housings because they believe it will control mold growth or prevent the release of dirt particles or fibers from ducts. These practices have yet to be fully researched and you should be fully informed before deciding to permit the use of biocides or chemical treatments in your air ducts. They should only be applied, if at all, after the system has been properly cleaned of all visible dust or debris.
fact is most homes have bad filter racks. when you insert the filter it doesn’t seal well to the sides so some of the air and dust bypass it and end up in the supply ductwork and into the house. Most of the dust in the supply ductwork settles down and doesn’t get blown in the house but some of it does when the blower starts up or when you put a new filter. If you have allergies or other health problems put in an electronic air cleaner, get your ducts cleaned and run the fan as much as you can afford. you can also get an ECM motor installed which is going to be worth it if you want to run the fan 24/7. If you have uninsulated metal ducts take down the ones you can and wash them. Then put them back and seal the joints. Cleaning the ductwork also improves airflow which is important to AC and Heat pump systems for efficiency. An electronic air cleaner will also improve airflow and static pressure because they usually have a much larger filter surface area. An electronic air cleaner also keeps the ac coil clean like new which means better efficiency and no cleaning needed. AC furnaces sometimes grow mold around the coil because of the condensation. Electronic air cleaners should be able to filter mold spores but the best remedy is installing a UV light next to the coil which will kill the mold.
Vinick calls air duct cleaning an essential part of home maintenance, akin to mopping and vacuuming. "It’s like changing the oil in your car,” he says. “If you don’t change the oil, you’re going to have a problem. When your components are loaded up with debris, the system has to work harder. When you remove that debris, you get energy consumption savings.”
You may consider having your air ducts cleaned simply because it seems logical that air ducts will get dirty over time and should be occasionally cleaned. Provided that the cleaning is done properly, no evidence suggests that such cleaning would be detrimental. EPA does not recommend that the air ducts be cleaned routinely, but only as needed. EPA does, however, recommend that if you have a fuel burning furnace, stove or fireplace, they be inspected for proper functioning and serviced before each heating season to protect against carbon monoxide poisoning.