Scanning is easy. OCR is easy. The part that comes next is hard and takes time. That is fixing the OCR errors and creating a good book out of it. The scanning and OCR can be largely automated and can be offered low costs. The rest is very much 'you get what you pay for'. So good quality means bigger bills. The end format is actually not that important, ePUB of Kindle. For a good Kindle book you also need a good ePUB (or so I am told).
PDF is absolutely the worst format to create an ePUB or Kindle book from. Most of these 'services' use a variant of Calibre to create their conversion, most without any form of post processing. Personally I am not to fond of the Calibre conversions. Mind you, that is my personal opinion. Calibre is a great product in itself.
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