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Under the lag areas there is much junk of no use, textures & objects dumped there by developers and never cleaned back up. You could make a new game (no mods) just to test the cleanup project, in console use TCL and go underground at least under the main layer. Do "Disable" and "markfordelete", recover with "Enable" before delete if unsure. GreenTech is also a junk area.
1) Set monitor to 144hz, turn on Freesync or G-Sync, for whatever GPU you have.
2) Set Enhanced Sync (AMD), Fast Sync (NVIDIA) in drivers.
3) Set V-Sync to OFF in game options.
4) Cap FPS to 144 in drivers. (must have a cap & must match monitor frequency)
Step down in numbers if you encounter speeding in convos that you cannot handle.
5) "Ultra Setting" is the wrong attitude for any game, do your research, but in this case it was done for you, adjust in-game settings accordingly: https://www.nvidia.com/en-us/geforce/news/fallout-4-graphics-performance-and-tweaking-guide/
Enjoy !