2013 Ford F150 3.5 V6 Ecoboost and should I tow with it??

I think the head replacement is just a symptom of modern throw away culture. A $.50 resistor goes bad on a computer board and you are told that you have to buy a new board for $200. No body wants to "fix" things anymore.

The issue is carbon buildup on the back side of the valves. I believe that very few dealers can do a "carbon and valve" job anymore. Have an independent shop pull the heads and clean it up. Minor cost compared to new heads.