[Question] Is Twilio programmable video the only "real" video call API out there?

I've been exploring building web apps with video calling capabilities recently, and it seems that - short of writing your own WebRTC with your own STUN/TURN server setup, Twilio's APIs are the only way to build a truly customized video calling service that will work across all platforms.

All others I've seen (Zoom SDK, Jitsi Meet) only seem to be "configurable" but not truly customizable.

I also tried writing the WebRTC code myself in native JS as well - ran into the NAT Traversal problem[0] which could be solved by either deploying my own TURN media server (too much effort + high cost) or once again, by using Twilio's Network Traversal service.

Are there any other services like the Twilio Programmable Video API[1] or Twilio Network Traversal[2] that will allow me to build a customized video calling experience? i.e., I have complete control over the positioning and look and feel of all the video streams in the call.

Seems to be that Twilio is the only player empowering developers to build their video calling apps - am I missing some alternatives?

[0] - https://webrtchacks.com/an-intro-to-webrtcs-natfirewall-problem