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It does cost money to change pictures and post top listings.
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Please note that it's free for providers to change photos once per month, but there is a cost for more frequent than that. Also, while Top10 Listings do cost (often, a pretty penny), it's completely free to log in frequently which bumps the listing to top place under the Paid Top Listings, which is #11 in a city.
We do require providers log in regularly and respond to reference requests. Some providers have a bit of trouble with this, and end up dropping off the site because it's "too much work".
Of course, many other providers drop off the site because of obligations in the personal lives that prevent them from continuing to provide. We remove inactive providers far more quickly than any other site I'm aware of, because sites tend to want their provider ranks to look more full... while we focus on having legitimate and responsive providers on the site.
It's a daily struggle though!
Always,
Gina