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Single $18.95
Two People $28.95
Family $39.95
Rates reflect payment by credit card or automatic deduction. For monthly payment by check, please add $2.00 to the total.
One time enrollment fee
Single $10
Two People $15
Family $20

Like Plan 595?

Best Coverage

California Dental’s Plan 595 offers the most coverage of our individual plans, including reduced specialist copays. It is a great choice for those who have not been to the dentist for awhile and
are looking to get started with a healthy smile. Plan 595 includes:

  • Preventive services, including cleanings, x-rays and check-ups at no charge
  • Fillings from $4.00 to $14.00
  • Extractions from $10.00 to $50.00
  • Root Canals from $140.00 to $180.00
Enhanced Specialty Coverage

Not all general dentists are capable of performing each of the services listed herein and, based upon the member’s condition, certain procedures may not be within the scope of practice or ability of a general dentist. In such cases, the general dentist will refer the member to a dental specialist. The plan will cover 30% of the specialist’s fees during the first year of enrollment and 50% thereafter, for up to $1000 in services per year.

Plan 595

Summary of Benefits and Copayments

Below is a summary of benefits that are available at participating California Dental providers

Your Copayment
Office Visit No Charge
Oral Examination No Charge
Intraoral x-rays, complete series No Charge
Bitewing x-rays, single film No Charge
Panoramic x-ray No Charge
Prophylaxis (cleaning) No Charge
Topical fluoride (child) No Charge
Oral hygiene instruction No Charge
Restorations Your Copayment
Amalgam, one surface $4.00
Amalgam, two surfaces $5.00
Amalgam, three surfaces $6.00
Resin, up to 3 surfaces $14.00
Temporary sedative filling $5.00
Oral Surgery
Extraction, Single Tooth $10.00
Surgical removal of erupted tooth $30.00
Removal of impacted tooth, soft tissue $40.00
Removal of impacted tooth, partially bony $50.00
Incision & drainage of abscess, intraoral soft tissue $14.00
Pulp cap, direct $5.00
Pulp cap, indirect $12.00
Thearapeutic pulpotomy $12.00
Root canal, anterior $80.00
Root canal, bicuspid $100.00
Root canal, molar $140.00
Gingivectomy or gingivoplasy, 4 or more contiguous teeth, per quandrant $100.00
Scaling & root planing, per quadrant $40.00
Crowns Your Copayment
Resin with metal* $156.00
Porcelain fused to high noble metal* (not for molars) $156.00
Porcelain fused to high noble metal* (for molars) $236.00
Full cast high noble metal* $142.00
3/4 cast metallic* $142.00
Prefabricated stainless steel, primary tooth $17.00
* Member is responsible for copayment plus actual lab cost of gold
Dentures & Prosthodontics  
Complete upper or lower denture $160.00
Upper or lower partial denture, resin base $150.00
Upper or lower partial denture, cast metal base with resin saddles $175.00
Adjust denture No Charge
Repair broken complete denture base $15.00
Replace missing or broken teeth, complete denture, each tooth $17.00
Reline complete or partial upper or lower denture, chairside $20.00
Reline complete or partial upper or lower denture, laboratory $42.00
Standard 24-month case
Full-banded, upper and lower, to age 19 $1695.00
Full-banded, upper and lower, adults $1695.00
Banded, upper or lower, children & adults $1000.00
Consultation $40.00
Broken appointments without 24 hour notice $40.00
Tooth colored fillings, on surface, back tooth $60.00
Bleaching, per arch $125.00
Labial veneer (porcelain laminate), laboratory $400.00
Night Guards, soft, includes lab fee $175.00
Bridge abutment porcelain fused to high noble metal $345.00
Bridge pontic porcelain fused to high noble metal $350.00